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Seven Questions to ask a Medical Billing Company

As more and more healthcare providers have realized the benefits of outsourcing medical billing to a professional medical billing company, there has been significant growth in the medical billing industry. And, with so many alternatives across the US, it's more important than ever that practices take great care in choosing the right partner for their medical billing needs. As you consider your options, here are seven of the most important questions to ask when interviewing potential medical billing services partners.

1. What type of experience do you have?

Does the medical billing company have the right experience for your specialty? Do they understand the coding nuances associated with your type of practice? What type of follow up do they provide with insurance carriers and other payers? What steps do they take in the event of a denied claim?

2. Where do you perform your work?

Today, private patient health information can be transmitted around the world instantaneously. Thus, it can be startlingly easy for your medical billing to be sent offshore to a facility tens of thousands of miles away without your knowledge. Even domestically, a medical billing company could be based on a loose network of home-based employees. Either possibility could have an impact on the quality of work, so make sure you understand where services will be performed and by whom. The safest option is usually to go with the traditional, brick-and-mortar office with in-house staff and face-to-face accountability before company management.

3. Are you HIPAA compliant?

It seems everyone in the healthcare industry today has at least a general familiarity with HIPAA- the new standard with for health information protection and security. But, since just about anyone can say they're HIPAA compliant, you'll want to make sure your potential medical billing company partner has demonstrated a complete understanding of the requirements. Do they talk about HIPAA compliance with an understanding of what it really means, as well as its impact on delivery of medical billing services? Can they discuss the specific steps they've taken in response to HIPAA?

4. What other steps have you taken towards increased security?

HIPAA requires healthcare professionals and medical billing companies take certain steps to secure patient information, but there are numerous other investments a medical billing company can make to go above and beyond. What other steps has the medical billing company taken beyond standard HIPAA compliance?

5. Can you discuss your specific processes and procedures?

Many medical billing companies are flexible enough to tailor a cafeteria-like solution to meet the needs of your practice, but are they clear on exactly how they work with you for each of the services you require? Make sure you understand what responsibilities each party will have in the partnership and the specific steps each will take in the process steps.

6. What are your costs and fees?

In the medical billing industry there are several different approaches to rate structures and fees. Practices should never enter an agreement without full and clear expectations on rates and how fees are calculated. The best bet is to look for a service that sets its fees up front and in writing to eliminate potential surprises down the road.

7. How will you keep my practice informed?

At minimum, any medical billing company should provide your practice with standardized regular reports- at least on a monthly basis. But what other types of reports is the medical billing company prepared to offer you, and how is this information communicated? Can reports be customized to your practice's specific areas of concern? If you find your medical billing company is not receptive to open exchange of information, they might have something to hide, or may not be as inclined to an open relationship as you might like.

As you evaluate your options for tackling the difficulties of medical billing consider these questions as a guide- and remember that the more information you have, the better prepared you'll be when it comes time to make a final decision. For more on how Pyramid's medical billing services address these questions and much more, contact Pyramid Medical today.

Pyramid offers a full range of medical billing solutions to practices across the US. We customize our medical billing solutions around helping your practice succeed and bring you Results…that make a difference!